Provider Demographics
NPI:1528811437
Name:PRITCHARD, LAYANNA (LPN, RN)
Entity type:Individual
Prefix:
First Name:LAYANNA
Middle Name:
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:LPN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 OAKLAND HEIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39307-5761
Mailing Address - Country:US
Mailing Address - Phone:601-227-6780
Mailing Address - Fax:
Practice Address - Street 1:6308 OAKLAND HEIGHTS ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39307-5761
Practice Address - Country:US
Practice Address - Phone:601-227-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS921245163W00000X, 163WH0200X, 163WW0000X
MS329479164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No164W00000XNursing Service ProvidersLicensed Practical Nurse